Provider Demographics
NPI:1437325644
Name:NASIR AHMAD MD PC
Entity Type:Organization
Organization Name:NASIR AHMAD MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NASIR
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-230-0383
Mailing Address - Street 1:1128 S LINDEN RD STE 10
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3454
Mailing Address - Country:US
Mailing Address - Phone:810-230-0383
Mailing Address - Fax:810-230-0035
Practice Address - Street 1:1128 S LINDEN RD STE 10
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3454
Practice Address - Country:US
Practice Address - Phone:810-230-0383
Practice Address - Fax:810-230-0035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301037454207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2955722Medicaid
0402503271OtherBLUE CROSS BLUE SHIELD
MI2955722Medicaid
0250327Medicare PIN